How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,514 to $11,749Professionalmedian $1,698 · 10th to 90th $1,349 to $2,692
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,905.46 Median $6,025.60 Typical High $10,964.78 | Facility | None | $1,905.46 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $354.81 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $309.03 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $309.03 |
CDPHP Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,309.57 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,584.89 | $1,584.89 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $5,888.44 | Facility | None | $1,659.59 | $2,041.74 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,819.70 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,238.72 | Professional | None | $954.99 | $1,445.44 | $2,238.72 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,698.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $4,265.80 | Professional | None | $1,778.28 | $1,905.46 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,659.59 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $6,165.95 | Facility | None | $1,148.15 | $1,513.56 | $6,165.95 |
Univera Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,445.44 | $2,238.72 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,148.15 Typical High $1,778.28 | Professional | 54 · Surgery only | $758.58 | $1,148.15 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $467.74 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $467.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $144.54 Typical High $223.87 | Professional | 56 · Pre-op care only | $95.50 | $144.54 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $933.25 Typical High $1,318.26 | Professional | 53 · Discontinued | $891.25 | $933.25 | $1,318.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,148.15 Typical High $1,778.28 | Professional | 54 · Surgery only | $758.58 | $1,148.15 | $1,778.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $933.25 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $933.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $144.54 Typical High $436.52 | Professional | 56 · Pre-op care only | $95.50 | $144.54 | $436.52 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $660.69 | $1,000.00 | $1,548.82 |
Where New York sits
The same service costs 18.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 43rd of 51
$1,698
AK $6,918TX $380
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.